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Mental Health in Fiction and How to Write it

Content warning for discussions of mental illness and mentions of suicide and self-harm.



Close up of a black and red typewriter, with the words 'Stories matter' typed out.
Photo by Suzy Hazelwood on Pexels


Mental health in fiction isn't anything new. Portrayals of mental illness go as far back as Ancient Greece to the likes of Shakespeare and Edgar Allen Poe. However, whether these portrayals were positive is a different conversation. They were a product of their time when madness (a now-dated and problematic term concerning mental health) needed to be locked up.


Nowadays we've grown more accepting of mental health and choose to showcase it the way it deserves. With that said, our media isn't one hundred per cent there yet in terms of accurate representation and many mental illnesses and disorders have little to no representation.


Fictional media has birthed harmful stereotypes about mental health. Those with mental health disorders like DID and schizophrenia are classified as violent and dangerous whilst other mental illnesses like depression are shown to be beautifully tragic, used to propel romance in a story, harmfully depicting love to be a cure-all potion.


Even with unfavourable depictions of mental health in fiction, it can still provide catharsis to those who suffer from mental illness as they have no other way to be seen. It shows them their struggles are real even if it paints an untrue picture to those unaware.


There are two sides to consider when depicting mental health in fiction:  those who suffer from it and those who don't. We need to create fiction that allows those who have mental health disorders to feel heard, to know they're not alone and to educate those oblivious to these issues. To help them gain an understanding of what it's like living with these hardships. Ultimately we should normalise mental health for everyone.


Before Pen Meets Paper


When it comes to writing about mental health there are many things to consider, especially if you don't suffer from any disorders. You most importantly want to write it accurately and tastefully without exemplifying any harmful stereotypes. You also don't want to overtake the voices of those within the community.


As with choosing to write about any topic, research is key. To portray mental health accurately you must delve into deep research about it. The first step would be to check the DSM-5 for the symptoms of mental disorders.



Whilst the DSM-5 can be good guidance and is used within the medical profession to help diagnose patients, it has been criticised for oversimplification. This has led to an issue with turning disorders into labels and misdiagnoses. It should thus be used to point you in a baseline direction.


Read non-fictional books and research papers, and even attend a course in psychology if you have the privilege to do so. This will help you gain a further understanding of how mental health disorders work, how they form and what's happening in the body.


The Human Touch


Research into the scientific side is advised but it's only one piece of the puzzle. You can't rely on that purely. You need to get inside the heads of those who suffer from the human angle. You should hear from the people themselves about how their mental illness affects the way they live, their relationships, their job or education etc. Learn to understand and empathise. Truly listen to those within the community.


One way to do this is by finding interviews, advocates online or people dedicating YouTube videos to bring awareness. Living Well with Schizophrenia and Hiba Azeem are a couple of YouTube channels committed to destigmatising and informing others about their mental illnesses. Another way to do this is by finding autobiographies written by those you so wish to represent or finding online forums where people come together to share their experiences. You can even take it further and ask questions on said forums yourself.


Sensitivity readers are a must! There's a good chance you will have to invest money into them but if you truly want to represent mental health, you want to find people who have experienced what you're writing about. They are there to read your manuscript, point out anything harmful or inaccurate with your work and offer suggestions.



Write People First


Mental illness may play a huge impact in people's lives but it does not define who they are. They exist outside of their mental health disorder(s) and would continue to exist without them. Traits can develop due to their diagnosis but one should not be defined by it. It is not a personality trait. It's a struggle, not a flaw. Your characters and stories should represent this.


Realise those who have mental illnesses are not a monolith. Be mindful that not everyone who experiences suicidal ideation or self-harm or neither is the same or perceives the world the same. Their outlook is influenced by a magnitude of things ranging from their country, culture, religion, gender, goals, social life, whether or not they have a physical disability and more. Anything and everything can impact their view on their diagnosis and themselves.


Consider what impact mental illness has on your characters as people. Is it the driving force? Is it in the background? How much does it truly shape your characters and the narrative if it shapes them at all?


It's nerve-wracking tackling something so sensitive. Those with mental illness aren't rare or strange. Their lives are like everyone else's. You don't want to add to the stigma that's already in place and harm the communities you're representing. You don't also want to overtake the voices you're trying to amplify. You want to be as human as possible.


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